Stroke and TIA Flashcards Preview

Hugh's MD2 Core Conditions and Presentations > Stroke and TIA > Flashcards

Flashcards in Stroke and TIA Deck (27):
1

Lobar strokes are usually due to what?

Amyloid angiopathy

AV malformations

Tumours

Aneurysms

Venous-sinus thrombosis

2

What are some conditions that mimic a stroke?

Seizure

Sepsis

Toxic/metabolite

Space occupying lesion

Syncope

3

Deep brain strokes are usually due to what?

HTN

Rupture of deep penetrating arteries

4

What is a semantic error of speech?

Mistake with word finding eg bus instead of train

5

What is a dysphasia?

Disorder of language

6

What are the new anticoagulants being used instead of warfarin?

Dabigatran

Apixaban

Rivaroxaban

Edoxaban

7

What is the risk of haemorrhage while on anticoagulants?

1-1.5% per annum

8

How do you differentiate a TIA from a seizure?

Seizure will have positive signs as well eg jerks or tingling

9

According to the CHADS2 scoring system, when are oral anticoagulants indicated?

If hypertensive and >75 years of age or,

Diabetes

Previous TIA

Heart failure

 

2 or more = Warfarin

10

How do you differentiate a TIA from a migraine?

All the symptoms will come on immediately with a TIA while they will progress more slowly with a migraine

11

What is a lacunar infarct?

Infarct result from occlusion of one of the deep penetrating arteries

12

What is the major difference between a stroke and TIA?

Permanent brain injury occurs in a stroke

13

When do you perform a carotid endarterectomy?

Generally if the stentosis is >50% or

If it produces symptoms

14

What percentage of strokes are intracerebral haemorrhages?

15% in Aus

15

What is a phemonic error of speech?

Error of the sound of a word eg last instead of past

16

What is the mechanism of action of Dabigatran?

Direct thrombin inhibitor

17

What is the CHADS2 score used for?

Assessing stroke risk for patients with non-valvular AF

18

What are the rates of recurrence in stroke patients?

5-10% within 1 week

10-20% within 3 months

19

What is the mechanism of action of Rivaroxaban?

Inhibitor of factor 10a

20

What is haemorrhagic transformation?

Haemorrhage post embolism in the setting of thrombolysis

21

What is the most common location for thrombotic occlusion in the brain?

Basilar artery

22

When does cavitation start to occur post infarction?

After 7 to 10 days

23

What is lipohyalination?

Introduction of lipids into arterial walls, typically in deep perforating arteries that can lead to a HTN haemorrhage

24

Outline your approach to assessing a patient with stroke on physical exam?

ABCs - Particularly the gag reflex

BSL

Neurological Assessment

- GCS

- Localising the lesions using focal signs

 

25

What are some pathologies that mimic the presentation of a stroke?

Space occupying lesions

Extra-axial haemorrhage

Venous sinus thrombosis

Metabolic: hyponatriaemia, hypo/hyperglycaemia, Wernicke's

Todd's paresis

Demyelinating disease

Migraine

Hysteria

26

What Ix would you perform in the acute setting for stroke?

Bloods - FBE, UEC, BSL, Coags, fasting blood lipids

12-lead ECG

CXR and CT brain (C-, angio, perfusion)

27

How do you approach the management of a patient with a stroke acutely?

IV access

Correct hypo/hyperglycaemia

Nil by mouth